Permit CITY OF TIGARD ' ELECTRICAL PERMIT
PERMIT #: ELC2005 -00618
DEVELOPMENT SERVICES DATE ISSUED: 8/23/2005
' ° I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S112BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 18 ZONING: R -12
SUBDIVISION: MARCIENE II APARTMENTS LOT : JURISDICTION: TIG
Project Description: (4) branch circuits for washer, dryer, water heaters & heaters. Job # R - 05 - 847.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
MICHAEL GORMAN ABC ELECTRIC
14655 SW 76TH 135 NE 9TH AVE
TIGARD, OR 97223 PORTLAND, OR 97232
Phone: 541 - 386 -1980 Phone: 503 - 233 -7551
FEES Reg #: LIC 26 -1226C
5096S
Description Date Amount SUP 16150
ELE 161501
[ELPRMT] ELC Permit 8/23/2005 $66.80
[TAX] 8% State Surcharge 8/23/2005 $5.34 REQUIRED ITEMS AND REPORTS
Total $72.14
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: _S.? 4._
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
AU' ' -2005 09:12 AM ,� p. 01
1o�triCal Permit ttioii e : ICL) Ft11: Oh'I`If,'I( Iltil: tlNl,l
City of Tigard tl � D ems': 1 -�7 �7 PermitNo.• r_ � QO, 1 ,
13125 SW Hall Blvd., Tigara, OR 97223 AUG 2 3 200 P1an Review
Phone: 503,639.4171 Fax: 503,598.1960 W ' +'�:� ; ai D Other Permit;
Inspection Line: 503.639.4175 ;! ' 1 ±, Date Ready /By: Juri : ® See Pape 2 for
Internet: www,ci,tigard.or.us CITY OF TIG ': 1 Notlll ed/lvsethod: Supplemental Information
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❑ Now construction i• Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: v azatd ue locatio
t'.'..t ':'; r,,. a •:. ;Jnp3' ^; ?a:;j :4;1:: .:::: ::.. ...:.. �......,,.;....... .. - g ,
Service o er 225 amps, comm'1 H o n
.._.,..,:.�...• ;.. .. ..,.. 10,000
j_ .i itaro l ..r�,a 4 t . �,.r r t : J• ..• •t .,... .... :,:': :.
t :,��.:li� fir;, n�s � t �t• a. c`."'"::.''•.°!• r, t'{. is�. �'' tw'::"_ ; ;::. ; :;:.:. ; : { .!;!:�.,:.::..c' •• •• •.:...- .:'•.:::._...: °'( oft- and2tamil 4ormorenewresident
k• If,�.k4:ul.}Y..._.r.,_, X111, f._.. i__. xi+ r_ i::.'.: iasL_...,,, �••"• 1.,,.,..,..., A._ r.._.. ._.._....- ._._..._......:...... .. ...,• ,• ._ ...:... . . ...... , ........,.:,:,
❑ 1- and 2- family dwelling `Q Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal unite in one structure
❑ Multi- family ❑ Master builder ❑ Other
.:., , p rsons red structul es or
wilding over three stories Feeders, 400 amps or more
S:4 : I SI `P.;; .• :!.:14i I.':� {,; t's: - ,_ _; •:;._- .-.:.- •::,:.- : :••: ::•; 1 •t =:r; . ;. :::.;:-:::;:::., cupan
Oc load vet• nu
o e a ac u
` "•' ❑Egress/ lighting plan RV park
a?OS. 5. •.....:.
Job no.: Job site address: � i ❑Health -care facility ❑Other:
Submit sets of plans with any of the above.
M �� v The above arc not applicable to temporary construction service.
Suite/bldg, /apt, no.: Pro ect name:j :.- ,,.. . a" r r 1 � �( t �7
' J � ,' r 1 . ` ; t .., . ,:' D . 1 1 :l" ...•r3 :Jai"r'tlr�i,: kiii. J i4. 1 rsr it` 4 11.1 1•,1 ir'11Ii!31
.� Denrlytl°a I Qty Pei, Total
Cross street/directions to job site: / . i r Oh rl New residential &Ingle- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. IL or leas 145.15 4
Subdivision: Y . L.r , , c) • �S Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no,: n gy'
;te a;s y!, p;:q. +. .•:! ;i':! -r, 1;:.: ;:!u; p. r : ::.rr ,. -•: -:- ;: :: e1'gy, n 75.00 2
m to a sidentia 75.00 2
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• • -•••• tm,tc cn on -reel anti,
?, tl�, f•.. a,..•.,. �„ �,.,..• kc{, t,.,•,,•,., ea. i~: :::..:.........._:,:;,:,..,.,.,:,...,,..:;:.,....,.....:..:.::::...:.:. .:::.:::...:.:,:.:::.:...�.:.:: •,.,.,, �,::..•..J.:....: • .., .::. ;' ..::';.� :: Each manufaactured or modular
dwelling, service and /or feeder 90.90 2
.�.. a ... /. / % /. Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
t ?1,.,.....•,.._„ ..::...:..:::_,• .�::: a - - _ :�.. -- - .!.,::.: 201 a s to 400 am s 106.85 2
,.........___,. ,.... _ 1 401 aretps to 600 amps 160.60 2
Name: ' '. - 0 a . vL 601 amps to 1,000 amps 240,60 2
Address: Over 1,000 amps or volts 454.65 2
Roconnect only 66.85 2
City /State /ZIP: Temporary services or feeders Installation, alteration, and /or
Phone: (TVA ��6* / I Fax: ( ) relocation
200 ffmps or less 66.85
Owner Installation: This installation is being made on property that I own Which is not 201 amps to 400 amps 100.30 - 2
intended for vale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
�+. , e:l,.,.l�;^:.,•::_ .,,..,.•..�:;::.:.: -1,:•, ..;,t A. Fee for bra
11 ,. -..,1: act: Ta•.,. a�...•..; k..• � .. ..:.......:..:.....:::..:.:.:.. • :.r:',;; <•'• :.. i . � f h
service or ee er ee, sac
' _I ,. ! branch circuit 6,65 2
B. Fee for branch citt;uits
Contact name: ar • _ without service or feeder fcc, i 46,85 �� p z
Address: each branch circuit /J
0 . • Each add'l branch circuit ._� 6.65 / 9' 2
Ctty /State /ZIP: Miscellaneous (service or feeder not included)
Phone :( )
Pump or irrigation circle 53.40 2
Sign or outline lighting 53.4o 2
E -mail: Signal ciroutt(s) or timited-
r`''` {!)h1, "J V:c1n j[ +(:Tulsa it ! :;Ia r:,tr ^.:[.. °_(tr�7rr: -';1't - _-
1 ,i• V,?t•a_L_ ,,,�: ;.,: i : i' star Inet alteration or
itt,.,1:a�,.3. t. i
5�1�1 -
cxtcnsion. each e: Page 2 2
= 1 /
Address: , �� , . , . each addltlonal Inspection over allowable In any of the above
Per inspection 62.50
• , • 4 lnvestigation per hour (I ter nun) 62.50
Phone: ( ) Industrial plant per hour 73.75
r 41 : f. ;i it t 1, la .iI 4 ! ,• P<r`anf i 41,1 ' • 'T`� ''s "; It?1� lr' -'u
-.,.. a M � pit t1' J� :.„ �,�hatil�Illlr ,lfl}l�ft,.�f r ,
1 , ( Suprv, Lic.: /' ; 4S0� Subtotal 6 6, _gD
Suprv. Electrician signature, required: .� ' Plan review (25% of permit fcc)
Date: a� — State surcharge (S °/a of permit fcc) `� 3 y
�' _. _ a / /, i 4 TOTAL. PERMIT FE$ 7 ..� • Y
Authorized signature: �_ �' � This permit application expires if a permit la not obtained within 180
days after 11 has been accepted as complete
' - Data: • Pee methodology set by T7i- Cotutty Building Industry Service Board
•• Number of inapeetlorts per permit allowed.
i:\8ulldln ➢\Fermis \ELC•PermitApp.doc 12/03 440- 461Sr(10/02/COM/W813
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005 00618
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/23/2005
Phone: (503) 639 -4171 � �1��
Inspection Requests (24 HTS.):s(503) 639 -4175 ,..#J0 `:_..
INSPECTION WORKSHEET FOR DATE: 1 /2005 TIME: 7:03AM PAGE: 38
SITE ADDRESS: 14655 SW 76TH A. 18 CLASS OF WORK:
SUBDIVISION: MARCIENE II APAR NTS LOT #: TYPE OF USE:
PROJECT NAME: MARCIENE H APTS
DESCRIPTION: (4) branch circuits for wash - dryer, water heaters & heaters. Job # R -05 -847.
OWNER: MICHAEL GORMAN, PHONE #: 541 - 386.1980
CONTRACTOR: ABC ELECTRIC N� % 0 N 11 p, 51 vJ Cb(LN &PHONE #: 503 2334551
Inspection Request Scheduled For:. Dat 8/31/2005 Pour Time:
Code # Inspection Description Confirm Contact # Message
199 Electrical final i X686 -0' 503- 233 -7551 Y
,,
Corrections /Comments /Instructions: I
11 -Al R ix
- - A -1 ti 9 xA
ASS ❑ PARTIAL APPROVAL CANCEL 1 1 NO ACCESS
1 FAIL 1 1 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G , ' " bV LE_ Date: _� Phone #: (503) 718-144‘